Objective: This study aims to review the pharmacology, efficacy, and safety of the
soluble guanylate cyclase stimulator,
vericiguat, in patients with symptomatic
congestive heart failure with ejection fraction less than 45% for the reduction of cardiovascular deaths. Also, to evaluate
heart failure-related hospitalization in patients following a hospital discharge secondary to
heart failure or those that require outpatient intravenous
diuretics. Data source: MEDLINE/Pubmed and National Institutes of Health Clinical Trial Registry were searched between January 1989 to February 2021 using the following terms:
vericiguat,
soluble guanylate cyclase stimulator,
heart failure, (was also known as)
BAY 1021189. Study Selection and Data Extraction: The following study designs were included in the analysis: phase I, II, and III clinical trials; systematic reviews; and meta-analyses. Articles were included if they were published in English and evaluated
vericiguat pharmacology, pharmacokinetics, efficacy, and safety. Data Synthesis: The Food and Drug Administration approved
vericiguat for the reduction of cardiovascular death and hospitalization after having a related hospitalization or the need for outpatient intravenous
diuretics, in those with symptomatic chronic
heart failure and ejection fraction less than 45%. In the VICTORIA trial,
vericiguat demonstrated
a 10% reduction in risk of death from cardiovascular causes or first hospitalization for
heart failure compared with placebo.
Vericiguat was well tolerated overall with
hypotension,
syncope, and
anemia noted as the most common side effects, similar to the other agent in its class. Conclusion:
Vericiguat may be appropriate as add-on
therapy for patients already on guideline-directed medical
therapy with recent decompensated HFrEF to reduce hospitalization.